Laserfiche WebLink
APPLICATIC-I FOR CONSTRUCT''1N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: >(GAS ❑ ELECTRIC ❑ <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATICN BUILDING YMECHANICAL ❑ PLUMBING J SIGN <br />OWNER n MAIL ADDRESS CITY ZIP PHONE <br />H.Fr�s 9os�-��i-r��r Fv�eETr 9P.�oi a7aro�-A�,/ <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE• <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP 9ffl�%34 PHONE <br />STATE LICENSER <br />=eE'29A - FNF/PGY <br />orYsr�rr <br />c /97�/ - S/�s Av€� 7�f«,.]iS <br />.Tor-w Lexo4z <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />YNNwo��CITY ZIP PHONE <br />STATE LICENSE <br />CWRACT P/RIICE OFIWORK <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <br />A fi <br />JfoLTI�I d Nt'7FLOC� %%'j�-�a��J <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAG. <br />r 5 as <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH TWO COPIES) <br />LOT - BLOCK OF — <br />PARCEL TAX I.D. NUMBER <br />- e42-A;?9-00/-D000 <br />CONSTRUCTION LOAN LENDER. ADDRESS, TELEPHONE NUMBER <br />PROJECT ADDRESS <br />EIGNAm^.r oeTe <br />C-TY BUSNLSS LFNer No <br />_ PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT_ <br />FEE <br />WATER CLOSET (TOILET) <br />A/C—ATHNDLG UNITS—H.P. <br />-11 <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />_ <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK S DISP - <br />; <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />, <br />LAUNDRY TRAY <br />/ <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />I <br />WOODSTOVE <br />URINAL <br />METAL FIRE -LACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />_ <br />FIREPLACE INSERT <br />; <br />FLOOR DRAIN <br />HEAT PUMP <br />B_ACKFLOW PREVENTERS <br />.,P- <br />_ <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />I <br />EXHAUST FAN <br />SINK (SERVICE —BAR. ETC.) <br />; <br />, <br />SUBTOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />_ <br />_ _ <br />PERMIT $ <br />- <br />TOTAL FEE $ <br />_ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPI NO. <br />USE ZONE <br />L07 AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />❑ YES ❑ NO <br />BUILDING <br />; <br />TYPE OF CONST <br />NO. OF STORIES <br />UCWPANCr <br />NB. Di MILLING UNITS <br />--- <br />PLUMBING <br />' <br />Geouv <br />1 <br />SIZE OF BLDG. <br />FIRE SPRINKLERS RED <br />BASEMENT <br />MECHANICAL <br />i <br />YES ❑ NO <br />— <br />ADDITIONAL PLAN CHECK <br />DDGNPANDY LOAD <br />FIRE ALARM REC'D <br />HEIGHT LIMITATION <br />OTHER <br />I <br />REASON <br />STATE BUILDING SURCHARGE <br />i <br />INTAKE BY <br />PLAN. APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />LOCAL SALES <br />DATE <br />TAX CODE IS 3105 <br />TOTAL <br />1% <br />